One Year Mortality Rate in Mechanically Ventilated Patients Admitted to a Long-term Acute Care Hospital (LTACH)

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 902A
Author(s):  
Jennifer Dixon ◽  
Michael Martinez ◽  
Frans van Wagenberg ◽  
Ying Fang ◽  
Cecilia Benz ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
One Year ◽  
Ventilated Patients

Acute Emergence of Elizabethkingia meningoseptica Infection among Mechanically Ventilated Patients in a Long-Term Acute Care Facility

2010 ◽  
Vol 31 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Kingsley N. Weaver ◽  
Roderick C. Jones ◽  
Rosemary Albright ◽  
Yolanda Thomas ◽  
Carlos H. Zambrano ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Facility ◽  
Acute Care Hospitals ◽  
Care Hospital ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Elizabethkingia Meningoseptica ◽  
Ventilated Patients

Objective.To describe an outbreak of infection associated with an infrequently implicated pathogen, Elizabethkingia meningoseptica, in an increasingly prominent setting for health care of severely ill patients, the long-term acute care hospital.Design.Outbreak investigation.Setting.Long-term acute care hospital with 55 patients, most of whom were mechanically ventilated.Methods.We defined a case as E. meningoseptica isolated from any patient specimen source from December 2007 through April 2008, conducted an investigation of case patients, obtained environmental specimens, and performed microbiologic testing.Results.Nineteen patients had E. meningoseptica infection, and 8 died. All case patients had been admitted with respiratory failure that required mechanical ventilation. Among the 8 individuals who died, the time from collection of the first specimen positive for E. meningoseptica to death ranged from 6 to 43 days (median, 16 days). Environmental sampling was performed on 106 surfaces; E. meningoseptica was isolated from only one swab. Three related pulsed-field gel electrophoresis patterns were identified in patient isolates; the environmental isolate yielded a fourth, unrelated pattern.Conclusion.Long-term acute care hospitals with mechanically ventilated patients could serve as an important transmission setting for E. meningoseptica. This multidrug-resistant bacterium could pose additional risk when patients are transferred between long-term acute care hospitals and acute care hospitals.

scholarly journals Long-Term Acute Care Hospital Outcomes of Mechanically Ventilated Patients With Coronavirus Disease 2019

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Marina Saad ◽  
Franco A. Laghi ◽  
John Brofman ◽  
Nidhi S. Undevia ◽  
Hameeda Shaikh
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Hospital Outcomes ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

scholarly journals Long-Term Acute Care Hospital Use of Non-Mechanically Ventilated Hospitalized Older Adults

2018 ◽  
Vol 66 (11) ◽  
pp. 2112-2119 ◽  
Author(s):  
Anil N. Makam ◽  
Oanh Kieu Nguyen ◽  
Lei Xuan ◽  
Michael E. Miller ◽  
Ethan A. Halm
Keyword(s):  
Older Adults ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Mechanically Ventilated ◽  
Hospitalized Older Adults ◽  
Hospital Use

scholarly journals Comparative Effectiveness of Long-Term Acute Care Hospital versus Skilled Nursing Facility Transfer

2020 ◽  
Author(s):  
Anil Makam ◽  
Oanh Kieu Nguyen ◽  
Michael E. Miller ◽  
Sachin J Shah ◽  
Kandice A. Kapinos ◽  
...  
Keyword(s):  
Acute Care ◽  
Inpatient Care ◽  
Acute Care Hospital ◽  
Healthcare Spending ◽  
Care Hospital ◽  
Skilled Nursing ◽  
Medicare Claims ◽  
One Year ◽  
At Home

Abstract BACKGROUND: Long-term acute care hospital (LTACH) use varies considerably across the U.S., which may reflect uncertainty about the effectiveness of LTACHs vs. skilled nursing facilities (SNF), the principal post-acute care alternative. Given that LTACHs receive over triple the reimbursement of SNFs for comparable diagnoses, we sought to compare outcomes and spending between LTACH versus SNF transfer. METHODS: Using Medicare claims linked to electronic health record (EHR) data from six Texas Hospitals between 2009-2010, we conducted a retrospective cohort study of patients hospitalized on a medicine service in a high-LTACH use region and discharged to either an LTACH or SNF and followed for one year. The primary outcomes included mortality, 60-day recovery without inpatient care, days at home, and healthcare spending.RESULTS: Of 3,503 patients, 18% were transferred to an LTACH. Patients transferred to LTACHs were younger (median 71 vs. 82 years), less likely to be female (50.5 vs 66.6%) and white (69.0 vs. 84.1%), but were sicker (24.3 vs. 14.2% for prolonged intensive care unit stay; median diagnosis resource intensity weight of 2.03 vs. 1.38). In unadjusted analyses, patients transferred to an LTACH vs. SNF were less likely to survive (59.1 vs. 65.0%) or recover (62.5 vs 66.0%), and spent fewer days at home (186 vs. 200). Adjusting for demographic and clinical confounders available in Medicare claims and EHR data, LTACH transfer was not significantly associated with differences in mortality (HR, 1.12, 95% CI, 0.94-1.33), recovery (SHR, 1.07, 0.93-1.23), and days spent at home (IRR, 0.96, 0.83-1.10), but was associated with greater Medicare spending ($16,689 for one year, 95% CI, $12,216-$21,162).CONCLUSION: LTACH transfer for Medicare beneficiaries is associated with similar clinical outcomes but with higher healthcare spending compared to SNF transfer. LTACH use should be reserved for patients who require complex inpatient care and cannot be cared for in SNFs.

scholarly journals Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anil N. Makam ◽  
Oanh Kieu Nguyen ◽  
Michael E. Miller ◽  
Sachin J. Shah ◽  
Kandice A. Kapinos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Acute Care ◽  
Inpatient Care ◽  
Acute Care Hospital ◽  
Healthcare Spending ◽  
Care Hospital ◽  
Skilled Nursing ◽  
One Year ◽  
At Home

Abstract Background Long-term acute care hospital (LTACH) use varies considerably across the U.S., which may reflect uncertainty about the effectiveness of LTACHs vs. skilled nursing facilities (SNF), the principal post-acute care alternative. Given that LTACHs provide more intensive care and thus receive over triple the reimbursement of SNFs for comparable diagnoses, we sought to compare outcomes and spending between LTACH versus SNF transfer. Methods Using Medicare claims linked to electronic health record (EHR) data from six Texas Hospitals between 2009 and 2010, we conducted a retrospective cohort study of patients hospitalized on a medicine service in a high-LTACH use region and discharged to either an LTACH or SNF and followed for one year. The primary outcomes included mortality, 60-day recovery without inpatient care, days at home, and healthcare spending Results Of 3503 patients, 18% were transferred to an LTACH. Patients transferred to LTACHs were younger (median 71 vs. 82 years), less likely to be female (50.5 vs 66.6%) and white (69.0 vs. 84.1%), but were sicker (24.3 vs. 14.2% for prolonged intensive care unit stay; median diagnosis resource intensity weight of 2.03 vs. 1.38). In unadjusted analyses, patients transferred to an LTACH vs. SNF were less likely to survive (59.1 vs. 65.0%) or recover (62.5 vs 66.0%), and spent fewer days at home (186 vs. 200). Adjusting for demographic and clinical confounders available in Medicare claims and EHR data, LTACH transfer was not significantly associated with differences in mortality (HR, 1.12, 95% CI, 0.94–1.33), recovery (SHR, 1.07, 0.93–1.23), and days spent at home (IRR, 0.96, 0.83–1.10), but was associated with greater Medicare spending ($16,689 for one year, 95% CI, $12,216–$21,162). Conclusion LTACH transfer for Medicare beneficiaries is associated with similar clinical outcomes but with higher healthcare spending compared to SNF transfer. LTACH use should be reserved for patients who require complex inpatient care and cannot be cared for in SNFs.

scholarly journals Investigation of a Group A Streptococcal Outbreak Among Residents of a Long-term Acute Care Hospital

2011 ◽  
Vol 52 (8) ◽  
pp. 988-994 ◽  
Author(s):  
M. Deutscher ◽  
S. Schillie ◽  
C. Gould ◽  
J. Baumbach ◽  
M. Mueller ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Group A
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